A client-centred ADL intervention: three-month follow-up of a randomized controlled trial

Scand J Occup Ther. 2014 Sep;21(5):377-91. doi: 10.3109/11038128.2014.880126. Epub 2014 Feb 10.


Objective: The aim was to study a client-centred activities of daily living (ADL) intervention (CADL) compared with the usual ADL intervention (UADL) in people with stroke regarding: independence in ADL, perceived participation, life satisfaction, use of home-help service, and satisfaction with training and, in their significant others, regarding: caregiver burden, life satisfaction, and informal care.

Methods: In this multicentre study, 16 rehabilitation units were randomly assigned to deliver CADL or UADL. The occupational therapists who provided the CADL were specifically trained. Eligible for inclusion were people with stroke treated in a stroke unit ≤3 months after stroke, dependent in ≥two ADL, not diagnosed with dementia, and able to understand instructions. Data were collected at inclusion and three months thereafter. To detect a significant difference between the groups in the Stroke Impact Scale (SIS) domain "participation", 280 participants were required. Intention-to-treat analysis was applied.

Results: At three months, there was no difference in the outcomes between the CADL group (n = 129) and the UADL group (n = 151), or their significant others (n = 87/n = 93) except in the SIS domain "emotion" in favour of CADL (p = 0.04).

Conclusion: The CADL does not appear to bring about short-term differences in outcomes and longer follow-ups are required.

Keywords: activity; caregiver; everyday occupation; goal setting; lived experience; multicentre study; occupational therapy; participation; rehabilitation; stroke.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Activities of Daily Living*
  • Aged
  • Aged, 80 and over
  • Caregivers / psychology*
  • Female
  • Follow-Up Studies
  • Homemaker Services / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Occupational Therapy / methods*
  • Patient-Centered Care
  • Personal Satisfaction
  • Quality of Life
  • Social Participation / psychology
  • Stroke / psychology*
  • Stroke Rehabilitation*
  • Treatment Outcome